Particulate vs. Non-Particulate Steroid for Sacroiliac Joint Injection
Particulate Versus Non-Particulate Corticosteroid in Sacroiliac Joint Injection: A Randomized Prospective Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Mark W Shilling, BS
- Phone Number: 505-925-7599
- Email: mwshilling@salud.unm.edu
Study Locations
-
-
New Mexico
-
Albuquerque, New Mexico, United States, 87131
- Recruiting
- University of New Mexico Hospital
-
Contact:
- Mark W Shilling, BS
- Phone Number: 505-925-7599
- Email: mwshilling@salud.unm.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Aged >18, capable of understanding and providing consent in English, capable of complying with the outcome instruments used, capable of attending all planned follow up visits
- Unilateral low back/buttocks pain of at least 2 weeks.
- Patient reported 7 day average of numeric pain rating score (NPRS) low back/buttocks pain of at least 5/10 at baseline evaluation
- Clinical diagnosis of sacroiliac joint pain as diagnosed by a board certified Physiatrist including history of low back/buttocks pain and at least 2 positive physical exam findings (including positive fortin finger sign, pain with palpation of posterior superior iliac spine, positive FABER's test, positive Gaenslan's test, positive sacral distraction, positive thigh thrust, positive lateral compression, positive sacral thrust)
- Patient consents to sacroiliac joint corticosteroid injection in a shared decision-making process with the treating physician.
- 80% or more relief of index pain within first 5-15 minutes after injection
Exclusion Criteria:
- Clinical suspicion of alternative process is greater than clinical suspicion of sacroiliac joint pain
- Those receiving remuneration for their pain treatment (e.g., disability, worker's compensation).
- Those involved in active litigation relevant to their pain.
- Those unable to read English and complete the assessment instruments.
- Those unable to attend follow up appointments
- The patient is incarcerated.
- History of prior sacroiliac joint fusion
- Progressive lower extremity neurologic deficit (from active radiculopathy, unhealed radiculopathy, or neuromuscular disease)
- Sacroiliac joint steroid injection within the prior 12 months
- 2 Positive lumbar medial branch blocks within the past 12 months
- Radiofrequency ablation of the lumbar spine within the past 12 months
- Lumbar facet steroid injections within the past 12 months
- Prior epidural steroid injection within the prior 3 months in any location within the spine.
- Possible pregnancy or other reason that precludes the use of fluoroscopy.
- Allergy to steroid, contrast media, or local anesthetics.
- BMI>40.
- Systemic inflammatory arthritis (e.g., rheumatoid arthritis, ankylosing spondylitis, lupus).
- Active infection or treatment of infection with antibiotics within the past 7 days.
- Medical conditions causing significant functional disability (e.g., stroke, decompensated ---COPD, decompensated heart failure)
- Chronic widespread pain or somatoform disorder (e.g. fibromyalgia).
- Addictive behavior, severe clinical depression, or psychotic features.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Non-Particulate Steroid
Patients in this arm will receive an injection of 1 milliliter of 2% lidocaine with 10 milligrams of dexamethasone to one or both sacroiliac joints.
If participants initially achieve relief from the injection but then have a return of pain they may be offered a second injection with the same drug at the same dose.
|
This is a non-particulate steroid commonly used to treat SI joint pain.
Other Names:
Lidocaine is a local anesthetic used in SI joint injection procedures to numb the procedure site and helps to confirm SI joint dysfunction when injected with the steroid medication into the SI joint.
Other Names:
|
|
Active Comparator: Particulate Steroid
Patients in this arm will receive an injection of 1 milliliter of 2% lidocaine with 40 milligrams of methylprednisolone to one or both sacroiliac joints.
If participants initially achieve relief from the injection but then have a return of pain they may be offered a second injection with the same drug at the same dose.
|
Lidocaine is a local anesthetic used in SI joint injection procedures to numb the procedure site and helps to confirm SI joint dysfunction when injected with the steroid medication into the SI joint.
Other Names:
This is a particulate steroid commonly used to treat SI joint pain.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pain using Numeric Pain Rating Score
Time Frame: 3 months
|
Numeric pain rating score is an 11 point scale (0-10) filled out on a form indicating the degree to which the patient experiences pain to assess efficacy of the injection.
In this scale a 0, the minimum score, indicates no pain at all with a 10, the maximum score, being the worst pain imaginable.
In this study a 50% or greater reduction in numeric pain rating score is considered a successful outcome while failure to achieve at least a 50% improvement as compared to their numeric pain rating score prior to the procedure is considered a poor outcome.
|
3 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Reza Ehsanian, MD, PhD, University of New Mexico Department of Anesthesiology and Critical Care
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Bone Diseases
- Musculoskeletal Diseases
- Spinal Diseases
- Joint Diseases
- Spondylosis
- Sulfur Compounds
- Organic Chemicals
- Hydrocarbons
- Hydrocarbons, Cyclic
- Hydrocarbons, Aromatic
- Polycyclic Compounds
- Anilides
- Amides
- Aniline Compounds
- Amines
- Acetanilides
- Pregnadienes
- Pregnanes
- Steroids
- Fused-Ring Compounds
- Steroids, Fluorinated
- Benzene Derivatives
- Sulfonic Acids
- Sulfur Acids
- Pregnadienetriols
- Benzenesulfonates
- Arylsulfonates
- Arylsulfonic Acids
- Prednisolone
- Methylprednisolone Acetate
- Dexamethasone
- Lidocaine
- Methylprednisolone
- Methylprednisolone Hemisuccinate
- Calcium Dobesilate
Other Study ID Numbers
Other Study ID Numbers
- UNM HRRC #23-503
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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